Healthcare Provider Details

I. General information

NPI: 1487458998
Provider Name (Legal Business Name): PREMIER DENTAL SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2025
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11130 N KENDALL DR STE 202
MIAMI FL
33176-0939
US

IV. Provider business mailing address

11130 N KENDALL DR STE 202
MIAMI FL
33176-0939
US

V. Phone/Fax

Practice location:
  • Phone: 305-271-7500
  • Fax:
Mailing address:
  • Phone: 305-271-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARIA E SOTO
Title or Position: INSURANCE COORDINATOR
Credential:
Phone: 305-271-7500